Provider Demographics
NPI:1548976608
Name:MURPHY, JULIE L (PHD, CRNP, PMHNP-BC)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:L
Last Name:MURPHY
Suffix:
Gender:F
Credentials:PHD, CRNP, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 CONCORD DR
Mailing Address - Street 2:
Mailing Address - City:WILKES BARRE
Mailing Address - State:PA
Mailing Address - Zip Code:18702-7309
Mailing Address - Country:US
Mailing Address - Phone:570-855-5242
Mailing Address - Fax:
Practice Address - Street 1:1425 SHOEMAKER AVE
Practice Address - Street 2:
Practice Address - City:WEST WYOMING
Practice Address - State:PA
Practice Address - Zip Code:18644-1020
Practice Address - Country:US
Practice Address - Phone:570-718-1996
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-23
Last Update Date:2023-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP026882363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health